After a tragic accident on the ice during a high school hockey game in Connecticut on Jan. 6, members of the hockey world have been reflecting on the safety of the sport. But there seems to be broad agreement that the blade injury that occurred that day was such an unusual and unlikely event that it will not directly result in new rules.

Teddy Balkind, a sophomore at St. Luke’s School in New Canaan, Conn., had fallen to the ice during a hockey game against the Brunswick School in Greenwich, Conn. A Brunswick player near him was unable to stop, and the two collided, according to a CNN report. Balkind suffered a blade wound to his neck and was immediately taken to Greenwich Hospital but later died as a result of the injury.

“We had a moment of silence, and we understand that we wake up every day and we give thanks,” said Drew Locke, head coach of the Nauset Regional High School boys ice hockey team. “There’s just not much you can do to prevent something so wild like that, other than being in control of your body at all times on the ice.”

To put the tragedy in some perspective, the National Hockey League (NHL) has suffered only one on-ice death in its history. It took place on Jan. 13, 1968 in Bloomington, Minn., according to bleacherreport.com. Bill Masterton of the Minnesota North Stars died after being hit by two Oakland Seals players on clean checks and hitting his head on the ice.

There have been incidents before of players’ necks being cut by skates, however. In 2008, Florida’s Richard Zednik had his neck sliced by the skate of teammate Olli Jokinen. Zednik survived the incident.

Carolyn Saluti, D.O. has a private practice in pediatric sports medicine in Plymouth. She said she treats many student athletes from the Cape.

“I hardly see injuries caused by blades,” she said. A doctor of osteopathic medicine, Saluti said she covered many hockey games for her sports medicine fellowship. She’d sit on the sidelines and hustle in if anything went wrong on the ice. Her husband is a referee, and two of her three sons play as well.

For an overview of hockey injuries, Saluti pointed to a 2019 study published in Sports Health titled “Epidemiology of Injuries in Ice Hockey.” According to the study, the most frequent injuries seen in youth hockey are contusions (36 percent of injuries), fractures (29 percent), sprains and strains (21 percent), and lacerations involving the head, neck, and upper extremities (7 percent). Saluti noted that helmet impact causes most of the lacerations she sees, not blades.

Asked whether neck protection might become required gear for the sport, John Maguire, executive secretary of the Mass. State Hockey Coaches Association, said, “I think it will be up to the individual parent, unless an organization like USA Hockey or the MIAA make them mandatory.”

Maguire, who has been coaching for 37 years, said that in that time he has seen very few high school players wearing neck guards and even fewer teams requiring them. “I have not seen an increase since the tragedy three weeks ago,” he said, “but I wouldn’t be surprised if some parents require their child to wear one at both the youth and high school level.”

The study Saluti cited did find that the risk of injury in hockey is higher at higher levels of play, likely due to increased player size, strength, and speed as well as a greater intensity of competition.

There are differences of opinion on body checking. “When you ‘check’ somebody, you’re hitting them to get possession,” said Locke. “You keep your stick on the ice, and you’re trying to knock the other guy off the puck.”

Body checking is not allowed in girls’ and women’s ice hockey, though “competitive contact” is allowed, according to USA Hockey, the nation’s governing body for the sport. For boys ages 14 and older, body checking is allowed, although USA Hockey, motivated by the concerns of medical professionals, recently raised the age threshold from 12 to 14.

“Doctors were talking about how these student athletes were still developing their bones and muscles,” said Tom Troiano, an Eastham resident and board member of Mass Hockey, a USA Hockey affiliate responsible for making the state’s rules. Troiano played college hockey at the University of Illinois at Urbana-Champaign and then coached the sport for more than 30 years.

“They were making good arguments about how body checking can impede skill development,” he added.

Saluti thinks waiting too long to learn body checking would only lead to more injuries.

“It’s better to start checking, or start learning to check, at that age of 14 or so,” said Dr. Saluti. “That way, they can master the skill before they become bigger and faster.”

“There’s always some disagreement within governing bodies of hockey with regard to highly skilled players versus recreational players,” said Troiano. At the youth level, the development of individual players can be tough to calculate.

“Sometimes, you get a weird matchup, where it’s a little guy against the big guy who can just throw him against the board,” said Mike Rabideau. He played professionally in the Federal Hockey League with the Brewster Bulldogs (based in New York) and then got into coaching. Rabideau holds private lessons for kids as a shooting specialist in Rhode Island and Massachusetts, including in Orleans. Prior to that, he trained NHL players for a brief stint.

“It’s always about hitting cleanly — and how you take a hit, absorbing the contact so you don’t go flying,” Rabideau said.

When heading toward the boards, if you’re too upright, if your base isn’t wide enough, and if your head is down and you’re not looking to see the play, you’re in trouble.

Troiano agreed, saying that in all his years of coaching he never taught much about getting cut by a skate but rather focused on how to hit the boards properly if you’re headed that way.

“The first thing you want them to do,” said Troiano, “is to get an arm or a leg out. If you hurt your wrist or shoulder, that’s easy to fix. But if you can’t, you’ve got to make sure your head is up. You want your nose to go into the board — not the top of your head. That’s where you get the spine injuries.”